Log onto Squarespace
Archives
« Article on Elective Cesareans: Some Thoughts | Main | Learning SquareSpace »
Wednesday
Aug272008

Welcome to My New House

I'm working on making it a home. I know you all will help.

Censorship is one thing, but losing one's words is another one entirely. Sarah and I backed up my entire blog (minus the comments, though... haven't figure out how to do that yet) so if anything happened before I could move it all over here, it was saved. I now have to do the same for my 20 Years of Birth Stories before I am flagged there, too. I will move it over here asap.

I received an email this morning from a woman who wrote me regarding the sad state of obstetric care and how she felt nothing would change until the perpetrators made the changes from the inside. She, a counselor in a sexual abuse healing center, writes in part:

One striking conclusion about violence against women that we have come to over the course of the last few years... is that as a predominantly woman based movement we will never achieve our desired outcome.  Our collective began reading some of Jackson Katz' work (The Macho Paradox: Why Some Men Hurt Women and How All Men Can Help) and actually had him come to speak at our centre.  One of his main concepts is that the perpetrators of violence against women are mostly male and without involving men as leaders and mentors in the movement for change... we will never succeed at ending sexual assault.
 
I think most of us have known that for a very long time and is why when someone wants to go to Med School to try and change things, most of us support them wholeheartedly. (I have a really hard time believing they will come out unscathed, however.)
 
Writing this woman back, I was reminded of the similarities of sexual assault and birth as we know it in the hospital. I wrote:
 
I absolutely understand. I've been working towards humanizing birth for almost 26 years now and it not only hasn't gotten better, it's gotten worse! I pray Dr. Wonderful takes on new OBs as "apprentices" and teaches them how glorious birth CAN/SHOULD be in the hospital setting. Alas, however, he is a pariah in the OB world, shunned and maligned like nobody's business. You would think that, as busy as his practice is, the other OBs would glom onto his style - maybe at least wonder, "What's he doing that I'm missing?" but no one seems to want to change!

As an incest and rape survivor, I have had my share of survivors over the years (you know how it goes, like seeks out like... even subconsciously). Loooooooonnnnnngggggg ago, before Penny Simkin even began researching her sexual abuse/birth book (and I know this because she and I had a discussion about the formulation of this thinking in about 1988 or so), I realized that epidurals were a serious cause of birth trauma for women. That, even as women were numbed physically, they carried with them body memories of penetration, pain and, in many ways, assault. They might not have physically felt those things, but on another level, their psyches were going to have to process all that shit that happened during the birth.

Bring on the postpartum depression for vulnerable women... women who had already been abused sexually, women who had a low tolerance for physical or psychic pain and even many psychologically healthy women whose bodies didn't realize what birth meant in this culture... the amount of assault, invasion and pain.

Now, I am also of the belief that women shouldn't suffer in birth and an epidural can be the most humane and conscious - and even HEALTHY - choice for some women. I know that some abused women need to have an epidural (or even cesarean) to be their most empowered. But that is a conscious decision, a consensual one, and women who make those choices seem to do really well postpartum.

I still believe women should be treated humanely when they have an epidural... the care provider asking permission to touch (which, by the way, I always do with my clients), explaining things as they are happening and thanking them for their help once the procedure/action is completed.

When I have women who have been sexually abused, I work with them on a birth plan that says these very things. It isn't that they are going to avoid vaginal exams altogether (in the hospital and possibly with me); that ain't happenin'. But they can be treated with respect and kindness... and the provider needs to take it SLOW with these women so they can process in their own time (unless a true emergency is occuring).

Of course, these are women who are aware of their sexual abuse histories. It is the women with repressed memories that suffer the most in birth, unaware of their body memories reacting to the vaginal exams, the IVs, the internal monitors, etc. THESE are the women I worry about the most.

For years and years, the media was filled with stories of sexual abuse. They, for the most part, are gone. Our culture has had its fill of sad stories and of women who flock to support groups to get help. Numb. I believe the incidence of abuse hasn't changed one iota, yet so, so many women are left alone to heal. Blessedly, there are a billion and a half books, but women stumbling through pain sometimes aren't even aware enough to know to read or talk to anyone.

I know that so many women with PPD have been sexually abused... it's flabbergasting that the information isn't widely known. How could someone, some researcher NOT see the correlation?

I know the change has to come from the inside out. For years we felt doulas would be the agents of change, but doulas have been transformed into The Enemy on most L&D wards. Midwives are rarely listened to (I can't even get Dr. Wonderful to quit doing perineal massage! Argh!) and medical school is so by rote, so regimented and unchanging, it's hard to imagine anything changing ever.

Yet, as a midwife, I strive to help women have a healthy experience, even if that means interventions or cesareans. My clients, for the most part, are VERY satisfied with their experiences and I can't help but think that it is because I work so hard towards building trust as well as telling the truth and details as things unfold, even if it is in the 2 minutes before EMS gets there.

I'm sure I have a lot to work on still, but I know that my own history has come into play (in a HUGE way) with my work as a midwife. And I'm glad. I think it makes me a better one.
 
Thoughts?
 

Reader Comments (14)

I thought you might like to comment on this recent Parent Dish article.

http://www.parentdish.com/2008/08/27/moms-bigger-risk-takers-when-birthing-than-their-doctors/

August 27, 2008 | Unregistered CommenterAshley

I read the article... thought about commenting... suspect I will now! Not sure if you'll like what I have to say though. ;)

August 27, 2008 | Registered CommenterNavelgazing Midwife

Congrats on your new digs. I just checked out squarespace offerings - looks great...you have me thinking about the whole backup thing.
Best,
DoulaMomma

August 28, 2008 | Unregistered CommenterDoulaMomma

You know, as a survivor of sexual abuse as a child, and as someone who volunteered at a women's shelter as a child and adult (mom worked there) it seems to me in the past 25 years of my life we are much more open about talking about sexual assault then we ever were before.

It's all tricky, all of it. Everyone has their own response to abuse, and means of dealing with it. I never recognized that it would be a problem with having children until I did have babies, I knew my trauma made me act differently when it came to my sexuality (usually young women are overly sexual or prudes if they've been abused.) It does make a difference how one deals with their abuse, and I wish part of the intake of a new prenatal care was asking if you had been abused in the past. However, I fear that with regimented care it would put you in one category of treatment when really it's how you are now that might really make the difference in outcome during labor and delivery. For myself an epidural allowed me to lose control over my body - it's been a control issue for me - and allow it to work the way it needs to, for my cervix to dilate. For another woman, being control means not losing sensation - I found myself fighting myself.

As for sexual assault that continues to occur, well I think that is wrapped up in valuing women and children. That is, we as a culture/society do not value women and children. We're cave people acting like we're not so primitive, and sexual assault is about control and men not being (it's most often men) responsible for their actions. With children we do not respect them as individuals, so they don't learn that they have a right to themselves or their bodies. We define human life as occurring at conception, which makes all sexually active and fertile women murderers since we know many fertilized eggs are shed with menstruation. Oh so many ways we value women less then a man's sperm, how we value our children less then for being our children then what they do/represent for us.

My goodness. Anyway, I do believe things are better then they once were - yes it's not headline news but I saw things getting better. Sexual abuse has always been with us, our response has changed a great deal in the last 30 years. It will take time, but with all things effort is needed. At least we're talking, and at least some of us are not only listening but being listened too!

August 28, 2008 | Unregistered CommenterEthel

I am now considering moving away from blogger after encountering the warning. As a midwifery student myself, I wonder if I will eventually face the same fate if I get too "objectionable". I am fascinated by your blog despite my extremely brief introduction to it. Thanks for fighting to stay and stay accessible.

August 28, 2008 | Unregistered CommenterTwo Hands

Very interesting and i suspect very true. Even for someone without a history of sexual abuse, to have decisions made for you can be devistating. Most of my birth team was AMAZING, but i did find that after the epidural and exhaustion kicked in, i was being talked over and not to. I also felt the anesthesiologist was rude and cold even though by the time i got it at 7cm i was suffering and compassion would have helped a great deal. You are so intuitive...i just love reading you insight. :)

August 28, 2008 | Unregistered CommenterRachael

I just "discovered" you via True Face of Birth, and I have to say I'm excited to have found you! This particular post has been very enlightening to me - as a newly trained, yet to be certified labor doula. I have no experience with this kind of trauma, but I know that I will, at some point, encounter it.

Thank you for being so open, and willing to share. I know I will learn a lot when I visit your site. :-)

August 28, 2008 | Unregistered CommenterFaerylandmom

I will say that I never felt vaginal exams bother me with my first five births. With my 6th birth, I felt the nurse was manipulating me, telling me lies, and not allowing me to do some simple things that gave me dignity (such as going to the bathroom). Not only that, but I felt her continually putting me flat on my back to push and also for cervical checks was putting my baby in danger. So, not only did I feel violated while she checked my cervix, tried to get the lip stretched and also did that stretching thing on my peri area while I was helpless there and not medicated one bit...but each time I worried there'd be another decel. I still, almost a year later, can feel the lump in my throat when I think how i just took it and didn't fight back. I have some anger because she had her fingers in me through two contractions at a time (many times) and it was ridiculous. I would tell her it hurt, and that didn't matter. I would also ask not to be on my back for pushing, and that didn't matter. I think it was the combo of her attitude toward me, the vulnerable state labor puts you in (after all, I could fight her but every few minutes I was hit with a contraction that took away my ability to talk). Labor is an intense time, and then all the touching, the lack of coverage and openness to the world when you try to keep yourself modest and covered in regular life...is just worse. Yes, you do lose some modesty when in labor and in pain.

When they are scaring you into thinking your baby is at risk so you have to stay in bed, then they knowingly put you flat on your back (which causes that blood vessel to be narrowed), the vaginal touching just makes one feel very oppressed. This from a woman who has given birth five times before and had MANY internal exams for these births and no problem with them whatsoever. I hope I never see that nurse again. Truly.

August 31, 2008 | Unregistered CommenterDawn

Honestly, I'm surprised and offended that your Blog was labeled "offensive." How vanilla and generic are the Blogs created there supposed to be? Your Blog was neither pornographic nor hateful, so I'm disappointed that it has "earned" that label.

That being said, I'm curious as to why you would want Dr. Wonderful to stop performing perineal massage. I certainly wouldn't want him to use the technique without first asking permission, but from what I understand it can be beneficial in preventing perenial tears. Is this information false or unconfirmed? Or would you simply prefer he not use perenial massage without first discussing it with his patients?

September 8, 2008 | Unregistered CommenterJackie

Perineal massage can be very damaging to the tissues and I see women tear a LOT more *with* the massage than when the perineum is left alone. Especially when the provider is aggressive with the tissue... and too many are.

Rarely does a Dr. Wonderful birth occur with a woman on her back, so if he were able to leave the perineum alone even once, I think he would see how much less his patients would tear. Love the man dearly, but that most of his patients have to be repaired can't be ignored.

September 8, 2008 | Registered CommenterNavelgazing Midwife

I just found your blog tonight, and I have fallen in love! I'm a survivor of childhood sexual abuse. I really never thought of it affecting my labors until my fifth pregnancy. I had decided, for various reasons, to birth at home. So we took the childbirth class provided by our midwife. The affect of sexual abuse was mentioned, and we were told that it would be a good and helpful thing if we were able to tell the midwife if we had such a history.

I had never heard that before. And it had never dawned on me.

I had pretty severe PPD with my first four children. It was horrible. None of my births had gone the way I wanted them to. I had an epidural each time. Yet this time, after having my baby at home, I didn't have any hint of PPD. Hmmm. I think I see a correlation!

This was a lovely post. Thank you for it!

October 2, 2008 | Unregistered CommenterMegan

Welcome! I hope you find the blog fun as well as educational. I am tending towards more serious topics lately, but I do throw fun things in, too.

I am so glad you had a great 5th birth! That is so wonderful. And what a great messenger you are, too, for empowered and (emotionally) safe births.

Thank you for being here.

October 3, 2008 | Registered CommenterNavelgazing Midwife

You can export an entire blog (all posts and comments) as an XML file (more info from the Blogger in Draft blog here).

Also, do you have an RSS feed from this site? I can't seem to find it, but I'd like to subscribe.

Thanks!

Oviously, I have already brought my whole blog over.

I don't know how to do RSS Feed. I've wondered how to do it for my blog... and how to "subscribe" for other blogs.

Anyone?

October 18, 2008 | Registered CommenterNavelgazing Midwife

PostPost a New Comment

Enter your information below to add a new comment.

My response is on my own website »
Author Email (optional):
Author URL (optional):
Post:
 
Some HTML allowed: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <code> <em> <i> <strike> <strong>